What to Know About Periodontal Scaling and Root Planing

Medically Reviewed by Poonam Sachdev on November 02, 2021
3 min read

Periodontal or tooth scaling and root planing are common dental procedures to treat gum disease, or periodontitis.

Gum disease — medically known as periodontitis — affects 47.2% of adults over age 30 in the U.S. About 8.5% of them may have severe periodontitis.

Gum disease is a severe infection or inflammation of the tissues that surround your teeth. It is caused by plaque that is continuously forming on your teeth. When bacteria builds up on the teeth, it can transform to tartar — or dental calculus. This film of bacteria can make your gums pull away from the teeth and form large pockets you can't reach with your toothbrush. You’ll need to see a dentist.

In the early stage, you may have reddening, swelling, and bleeding of your gums, a condition called gingivitis. If left untreated, gingivitis can lead to gum disease, tissue damage, and bone and teeth loss.

The good news is, gum disease can be prevented with proper teeth and gum care and regular dental visits.

Dentists typically use periodontal scaling and root planing as the first steps in the treatment of gum disease.

Periodontal scaling and root planing are nonsurgical. They are more of a deep cleaning that is done with handheld instruments or ultrasonic devices.

Researchers say that deep cleaning with ultrasonic instruments has similar results to manual deep cleaning with handheld instruments. Both treatments produce significant clinical results, but ultrasonic cleaning is faster, taking 20% to 50% less time than manual cleaning.

Your dentist may first apply a topical or local anesthetic to numb the area in your mouth where they’ll be working.

Your dentist will scrape away all your plaque and tartar on your teeth — scaling -- both above and below your gum line, down to the periodontal pocket.

After removing plaque, your dentist will plane, or smooth out, the rough surfaces on the roots of your teeth. This will help your gums reattach to your teeth.

Depending on your condition, periodontal scaling and root planing may take more than one dental visit. After this treatment, you may need a post-procedure checkup.

Dental scaling and root planing could introduce harmful bacteria into your bloodstream — leading to bacteremia or blood infection.

Your dentist may prescribe a mouth rinse or antibiotics to prevent infection and help you heal. 

Scaling and root planing typically leave gums painful for a few days and the teeth sensitive for up to a week. Your gums may bleed and feel swollen or tender right after the treatment.

Most cases of chronic gum disease are successfully controlled by removing bacteria and calculus during periodontal scaling and root planing. But some factors may affect how your teeth respond to the treatment:

If your periodontitis is severe, you may need dental surgery. This includes:

  • Soft tissue grafts. A small amount of tissue is removed from the roof of your mouth and attached to the affected area.
  • Flap surgery — or pocket reduction surgery. Here, tiny cuts are made in your gums to lift your gum tissue. This exposes your roots for better scaling and root planing.
  • Bone grafting. If gum disease has destroyed the bone surrounding your teeth, you may need a bone graft. In this procedure, a surgeon uses a transplanted bone to rebuild a damaged one. 
  • Tissue-stimulating proteins. Here, a gel that stimulates bone and tissue growth is applied to the root of an infected tooth.
  • Guided tissue regeneration. When gaps between the teeth and bone become too deep, a piece of biocompatible material is placed into the pockets to help promote bone cell growth.

Regular teeth and mouth care is important for gum disease prevention and recovery after periodontal scaling and root planing. Proper dental care at home, along with a balanced diet, can help you preserve treatment results and prevent future gum problems.